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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A differentiation between the normal sensation of tiredness and the symptom "fatigue" is often difficult. Both are influenced by cultural, social, psychological and biological factors, which can lead--interactively--to symptom formation. Psychiatric disorders frequently associated with fatigue are all forms of depression, somatization and anxiety disorders, chronic pain states and drug abuse among many others. In at least 2/3 of patients with the fashionable chronic fatigue syndrome--formerly called neurasthenia--a psychiatric diagnosis can be made, most of them also suffer from many symptoms attributes to the autonomous nervous system. The clinical approach should be cautious avoiding diagnostic and therapeutic overaction and therapy should emerge from a diagnosis properly assessed.
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PMID:[Intense fatigue in humans. Psychosocial and cultural aspects]. 175 73

The population resident in the skilled nursing home of a Veterans Administration Hospital on the 27th of June 1988 was screened for the presence of depression. Only 74% of the patients (59 of 80) were able to complete most of the screening battery: the Folstein Mini-Mental State Examination, the 15-item Geriatric Depression Scale, and the Hamilton Depression Scale. Thirty-four percent of the sample (20 of 59) met the criteria for a DSM-III-R psychiatric diagnosis; 22% (13 patients) had a major depressive disorder, and 12% (seven patients) had an adjustment disorder with depressed mood. The 15-item version of the Geriatric Depression Scale was more effective than the Hamilton Depression Scale as a screening instrument in this population of frail elderly veterans who had multiple and severe medical problems (end-stage cardiac disease, progressive myasthenia gravis, terminal pulmonary disease, and multiple cerebrovascular accidents) that limited verbal and nonverbal communication, as well as physical endurance.
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PMID:Screening a skilled nursing home population for depression. 178 10

The postviral fatigue syndrome overlaps with psychiatry at a number of points. First, there is the influence that some psychological states have on physiological processes, such as immunity. Second, psychological symptoms, particularly depression but also anxiety, are a major feature of the syndrome. Third, difficulties in the doctor-patient relationship are common. Each of these three areas are discussed in detail. Special attention is given to the possible mechanisms underlying the occurrence of psychological symptoms, which are sufficient to make a psychiatric diagnosis in at least two thirds of cases. It is concluded that the bulk of the scientific evidence points to psychiatric disturbances being primary but that this does not account for the syndrome in its entirety and other mechanisms probably operate as well. Much of the conflict between doctor and patient arises from misconceptions about the nature and cause of psychological disturbances.
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PMID:Postviral fatigue syndrome and psychiatry. 179 94

Transcultural research into psychopathology has often failed to produce a systematic body of findings concerning the relationship between culture and psychopathology. In this paper an attempt is made to overcome this problem by examining the relationship between culture and depression in terms of a theoretical task. Japanese and Australian depressed patients were given measures of depression and decision making. The relationship between specific variables associated with depression and those associated with decision making was investigated. Results showed that those depression variables which influenced decision making for Japanese patients were different to those for Australian patients. These findings are discussed in terms of their implications for psychiatric diagnosis and understanding the relationship between culture and depression.
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PMID:Cultural influences on depression: a new methodological approach and its results. 180 Aug 3

46 subjects infected with human immunodeficiency virus (HIV) were followed up to determine psychiatric morbidity, both prior to and after information regarding their HIV status was revealed to them. Among these patients, 4 had AIDS syndrome while 42 individuals were HIV carriers. The preinformation morbidity in the AIDS group included 2 individuals who presented with delirium and 1 with an adjustment disorder. The psychiatric diagnosis among the HIV carriers revealed 1 patient with major depression, 4 with adjustment disorders, and 4 with alcohol dependence syndrome. The additional morbidity after the diagnosis was revealed and included major depression and adjustment disorders which could be managed by psychological intervention and counseling in most instance. The individual who later developed major depression committed suicide. The study, though preliminary in nature, suggests that it may be beneficial to include psychiatric management as past of the general care of individuals with HIV infection.
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PMID:Psychiatric morbidity in HIV infected individuals. 185 20

Specialist psychiatric services run by the Italian National Health Service are mainly hospital-based in North-Verona and community-based in South-Verona. Ninety-two GPs from both areas participated in a one-day survey of their provision of psychiatric care, and this paper focuses on socio-demographic and clinical variables associated with specialist psychiatric referral. The one-day prevalence figure for GP referral to specialist psychiatric services was 7.3% (17.6/10,000): the figures did not differ between the sexes or between the two areas. Whereas in North-Verona 49% of the patients referred were sent to the two local hospital-based public services and 51% to other agencies (mainly to private psychiatrists), in South-Verona 71% of referrals were to the community-based public service. Log-linear analysis showed that past psychiatric history, psychological presenting complaint, social problems and GPs' psychiatric diagnosis exerted positive joint main effects on GP referral to specialist psychiatric services, and that diagnosed organic illness had a negative effect in this regard. In the presence of a psychological complaint, a psychiatric diagnosis proved to be quite unimportant, so that those without a psychiatric diagnosis were just as likely to be referred as those with one. However, in the absence of a psychological complaint a GP diagnosis of depression greatly increased the risk of referral. Though the type of psychiatric service proved not to be an important determinant of GP referral to specialist psychiatric services it influenced the GPs' choice of referral agency.
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PMID:General practitioner referral to specialist psychiatric services: a comparison of practices in north- and south-Verona. 187 53

The present study examined the relationship among psychiatric diagnosis, depression, attributional style, and hopelessness among 69 adolescent suicide attempters and 40 psychiatrically hospitalized adolescent controls. Contrary to predictions, the suicide attempters were more likely than the nonsuicidal group to attribute good events to global causes. No differences in attributional style were found across the depressed versus nondepressed subjects. However, there was a modest relationship between depression and attributional style. Results suggest that maladaptive cognitive characteristics are present in adolescent clinical samples but may be less specific to suicide attempters than is often suggested.
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PMID:Cognitive characteristics of adolescent suicide attempters. 189 94

To characterize the effects of trauma sustained more than 40 years ago, prevalence of psychiatric disorders and personality dimensions were examined in a sample of 62 former World War II POWs. The negative effects of their experiences are reflected in their multiple lifetime diagnoses and in their current personality profiles. Fifty percent met DSM-III posttraumatic stress disorder (PTSD) criteria within 1 year of release; 18 (29%) continued to meet the criteria 40 years later at examination (chronic PTSD). A lifetime diagnosis of generalized anxiety disorder was found for over half the entire sample; in 42% of those who never had PTSD, 38% of those with recovery from PTSD, and 94% of those with chronic PTSD. Ten percent of those without a PTSD diagnosis had experienced a depressive disorder, as had 23% of those with recovery from PTSD and 61% of the POWs with chronic PTSD. The combination of depressive and anxiety disorders also was frequent in the total sample (61%). Current MMPIs of three groups with psychiatric diagnosis were compared with those of POWs who had no diagnoses and with a group of Minnesota normal men. Profile elevations for the groups, from highest to lowest, were: POWs with chronic PTSD, POWs with recovery from PTSD, POWs with other psychiatric diagnoses, POWs with no disorders, and Minnesota normal men. Symptoms of anxiety, depression, and somatic concerns combined with the personality styles of suppression and denial characterize the current adjustment of negatively affected POWs.
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PMID:Comorbidity of psychiatric disorders and personality profiles of American World War II prisoners of war. 200 87

Depressed mood and the psychiatric diagnosis of major depressive episode (MDE) are common findings in patients with chronic fatigue syndrome (CFS). The relationship between depression and CFS is unclear and may be explained by one of four models: (1) CFS is an atypical manifestation of MDE; (2) depression is the result of CFS as either an organic mood syndrome or an adjustment reaction; (3) CFS and MDE are covariates; and (4) the diagnosis of MDE is artifactual. The evidence for these models is discussed. The potentially confounding effect of depression on tests of immune function and neuropsychological testing is described. The implications of these different models for the design of studies of CFS are examined.
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PMID:Chronic fatigue syndrome and depression: cause, effect, or covariate. 202 Aug 5

Although the clinical interview retains a central role in psychiatric diagnosis, recent research has suggested that "biological markers" may ultimately increase the precision of clinicians' nosologic and therapeutic decisions. Evaluating and operationalizing diagnostic tests require mathematical techniques that reflect the tests' essential features and limitations, and that guide clinicians in particular clinical situations. In this article we describe a technique that combines signal detection theory and utility-based decision theory, and apply the technique to published data in which sleep architecture was used as a biological marker for depression. We show how outcome utilities influence the optimum REM latency cut-off and show how this relationship is influenced by the prevalence of depression in the population being tested. We also make specific calculations of the practical limits that must be imposed on uncertainties in utilities to operationalize a diagnostic test for a specific clinical situation.
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PMID:"Biological markers" and psychiatric diagnosis: risk-benefit balancing using ROC analysis. 205 54


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